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Hand-held Doppler as a screening test in primary varicose veins

W B Campbell1, P G Niblett, B M Ridler

  • 1Department of Surgery, Royal Devon and Exeter Hospital, UK.

The British Journal of Surgery
|December 11, 1997
PubMed

Insights

Hand-held Doppler is a useful screening tool for varicose veins, missing only 11% of cases, primarily those with low-velocity reflux. This suggests it

Area of Science:

  • Vascular Surgery
  • Medical Imaging
  • Diagnostic Ultrasound

Background:

  • Hand-held Doppler is widely used for varicose vein evaluation.
  • Its accuracy in pinpointing venous reflux sites is less than duplex scanning.
  • Duplex scanning for all varicose veins is impractical; hand-held Doppler's adequacy as a screening tool is debated.

Purpose of the Study:

  • To assess the diagnostic accuracy of hand-held Doppler for primary varicose veins.
  • To determine if hand-held Doppler is a sufficient screening method before considering duplex scanning.

Main Methods:

  • Eighty-five patients (122 legs) with primary varicose veins were evaluated.
  • A standardized protocol using hand-held Doppler was applied in an outpatient setting.
  • Venous duplex imaging was performed subsequently for comparison.

Main Results:

  • Assessing the long saphenous vein (LSV) using various hand-held Doppler methods showed 75-86% sensitivity for reflux detection.
  • Combined methods identified 91% of LSV reflux cases; missed cases often had low-velocity reflux.
  • Hand-held Doppler missed 11 cases of popliteal fossa reflux, mostly low-velocity.

Conclusions:

  • Hand-held Doppler examination missed long saphenous vein (LSV) or short saphenous vein (SSV) incompetence in 11% of legs.
  • These missed cases predominantly involved short-duration and low-velocity reflux.
  • The clinical significance of missed low-velocity reflux requires further consideration.
Abstract

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